AHCCCS is requesting an amendment to the 1115 Research and Demonstration Waiver to seek a waiver of the Institution for Mental Disease (IMD) exclusion for all Medicaid beneficiaries aged 21-64, regardless of delivery system. The objective of this waiver is to maintain and enhance beneficiary access to behavioral health services in appropriate settings and ensure that individuals receive care in the facility most appropriate to their needs. Specifically, the waiver of the IMD exclusion would allow psychiatric facilities (i.e. hospitals, nursing facilities, or other institutions of more than 16 beds that are primarily engaged in providing diagnosis, treatment or care of persons with mental diseases, including medical attention, nursing care and related services) to be able to provide reimbursable services to Medicaid recipients for stays in excess of fifteen (15) days
AHCCCS is hosting community meetings across the state to provide the public with information about the upcoming Waiver submittal. These sessions will also provide the opportunity for AHCCCS to hear from stakeholders, including members and their families, advocates and providers.
| Public Forum Locations | Dates |
|---|---|
| Tucson Pima County Library Lower Level 1 Meeting Room 101 N. Stone Ave. Tucson, AZ 85701 |
Date: February 14, 2017 Location: Tucson, Arizona Time: 1:30 pm – 3:00 pm |
| Phoenix AHCCCS—Gold Room, 701 E. Jefferson St, Phoenix, AZ 85034 |
Date: February 15, 2017 Location: Phoenix, Arizona Time: 1:00 pm – 3:00 pm Conference call-in number: 1-877-820-7831 Participant Passcode: 976852 |
| Flagstaff Flagstaff AquaPlex 1702 N Fourth St, Flagstaff, AZ 86004 |
Date: February 16, 2017 Location: Flagstaff, Arizona Time: 1:00 pm – 2:30 pm |
The public will have the opportunity to review and comment on the proposal in person at public forums throughout the State and in writing via e-mail to publicinput@azahcccs.gov or mail to:
AHCCCSAll comments received by March 20, 2017, will be reviewed, considered and included in the final proposal sent to CMS.
June 5, 2017
As of June 2, 2017, the Centers for Medicare and Medicaid Services (CMS) has indicated that currently there is only a path forward for an IMD waiver for individuals with substance use disorder needs, as part of a comprehensive state substance use disorder (SUD) strategy. AHCCCS will move forward with the submitting such comprehensive strategy, and will comply with the IMD provisions of the managed care regulations for individuals with non-SUD behavioral health conditions.
In the upcoming weeks, AHCCCS will revisit strategies identified by MCOs and providers to continue discussions related to compliance with this regulation.
April 12, 2017
Today, AHCCCS submitted to Centers for Medicare & Medicaid Services (CMS) a request for a waiver from restrictions on federal funding for services provided to Medicaid beneficiaries aged 21-64 who receive inpatient services in an Institution for Mental Disease, regardless of delivery system. With this approval, AHCCCS would maintain and enhance beneficiary access to behavioral health services.
November 18, 2016
On July 05, 2016, a new Federal regulation from the Centers for Medicare and Medicaid Services (CMS) became effective which limits Federal funding for services to persons in IMDs who are aged 21-64. Federal Rule 42 C.F.R. 438.6(e) prohibits Federal Medicaid funding to Managed Care Organizations when members aged 21-64 are in IMDs for more than 15 days during a calendar month. AHCCCS understands the significant impact of this change and is collaborating with Managed Care Organizations to implement these changes. Managed Care Organizations are also working with providers to implement strategies which maximize continuity of care for members.
